Provider Demographics
NPI:1972537124
Name:POND, LORA G (OD)
Entity type:Individual
Prefix:DR
First Name:LORA
Middle Name:G
Last Name:POND
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:7075 REDWOOD BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-4136
Mailing Address - Country:US
Mailing Address - Phone:415-897-2997
Mailing Address - Fax:415-898-3626
Practice Address - Street 1:7075 REDWOOD BLVD STE F
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-4136
Practice Address - Country:US
Practice Address - Phone:415-897-2997
Practice Address - Fax:415-898-3626
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA8008T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist